What causes hemorrhoids to bleed?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 08, 2024
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Internal hemorrhoids can easily cause rectal bleeding. The main reason is the varicosity of hemorrhoidal veins. During defecation, dry and hard stools scratch the hemorrhoidal veins causing them to rupture and bleed. Additionally, due to the long-term presence of hemorrhoids, the hemorrhoidal veins become overstretched, making the vein walls thin and fragile, and easily damaged during bowel movements. For hemorrhoid-induced rectal bleeding, treatment can be administered through medications aimed primarily at reducing bleeding symptoms and alleviating the varicosity of the hemorrhoidal veins. Sitz baths can also be used to reduce swelling around the anus. If medication provides limited relief, minimally invasive or surgical treatments may be considered.

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Written by Jia Rui
Obstetrics and Gynecology
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Does hemorrhoids affect natural childbirth?

Women with hemorrhoids during pregnancy can affect childbirth. It is recommended to first treat the hemorrhoids. If the condition of the hemorrhoids is severe, it is also not suitable to treat during pregnancy. In such cases, methods like cesarean section may be adopted for childbirth. Additionally, some topical ointments can be used to locally treat hemorrhoids, which are effective in relieving symptoms such as swelling, pain, and bleeding caused by hemorrhoids. During pregnancy and while suffering from hemorrhoids, spicy foods should be avoided. (Medication should be used under the guidance of a doctor based on specific conditions.)

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Written by Xu Jun Hui
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Do hemorrhoids bleed?

Hemorrhoids can progress to a stage where there is rectal bleeding characterized by bright red blood that is separate from the stool. This is caused by the severe tortuosity and dilation of the superior hemorrhoidal veins. As the hemorrhoids worsen, congestion and dilation of the hemorrhoidal venous plexus become more pronounced. In the presence of bowel dysfunction and hard stools, the hemorrhoidal venous plexus can be injured, leading to rupture and bleeding. Initially, the bleeding is typically minimal yet frequent. Over time, this may lead to frequent and substantial bleeding. Chronic bleeding from hemorrhoids can cause chronic blood loss anemia, which impacts the physical and mental health of the individual.

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Written by Yu Xu Chao
Colorectal Surgery
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How to treat hemorrhoids bleeding

In clinical practice, the treatment of hemorrhoidal bleeding primarily depends on the severity of the bleeding. If a patient experiences frequent hemorrhoidal bleeding and the volume of blood loss is significant, it is recommended to adopt surgical treatments early. Prolonged bleeding can lead to severe anemia, severely impacting the patient's health. Possible surgical options include sclerotherapy, internal hemorrhoid ligation, or surgeries like PPH and TST. However, if the hemorrhoidal bleeding is infrequent and the volume of blood loss is minimal, the first step should be to improve the diet. Consuming more seasonal fresh fruits and vegetables, maintaining smooth bowel movements, not spending too long on bowel movements or straining excessively, and using hemorrhoidal suppositories or ointments for anal administration after bowel movements are recommended.

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Written by Ren Zheng Xin
Gastroenterology
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How often does hemorrhoids cause bleeding?

Internal hemorrhoids can cause rectal bleeding, typically occurring during defecation, ranging from dripping to jet-like bleeding. Rectal bleeding is painless, and prolonged bleeding can lead to anemia characterized by loss of appetite, fatigue, and lack of concentration. It is important to timely apply hemostatic medications or opt for treatments like electrocoagulation, banding, or surgery. Dietary adjustments should be made by increasing the intake of vegetables and fruits and reducing spicy, greasy, and irritating foods. Regular routines should be maintained, avoiding prolonged sitting, and using warm water for sitz baths every evening can effectively relieve the symptoms of hemorrhoidal venous dilatation.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do if hemorrhoids are bleeding?

Hemorrhoids that bleed should be treated to stop the bleeding as soon as possible. The common clinical symptoms of hemorrhoids mainly include localized bleeding, repeated prolapse of the internal part of the anus, and pain. Early bleeding can be managed with oral hemostatic medications, application of hemorrhoidal creams to the anal area, and use of anal plugs with thrombotic agents for comprehensive treatment, for minor bleeding. The symptoms can be relieved with medications. However, if the bleeding lasts long or if there is a greater amount of bleeding from mucous membranes and the bleeding points are fragile, further surgical ligation may be necessary to stop the bleeding. Common surgical methods mainly include excision of mixed hemorrhoids, internal ligation, or hemorrhoid banding procedure, and can also be combined with submucosal sclerotherapy injections.